- Cardiac troponin at 4 months after an acute coronary syndrome (ACS) event predicts risk for cardiovascular (CV) death.
- The 1 in 10 patients with highest values warrants close monitoring because of high risk (almost 10% annual incidence of cardiovascular death), with optimized cardiovascular care.
Why this matters
- The role of testing high-sensitivity cardiac troponin in the months after an ACS has not been clear, but these results suggest potential for improving patient follow-up, say the authors.
- Values were obtainable in 99.0% of patients at 4 months.
- Troponin predicted cardiovascular death independently: HR, 1.4 (95% CI, 1.3-1.5 for each doubling in values).
- Compared with patients with values ≤5 ng/L, those with values above the 99th percentile (9.3% of them at 4 months) had an almost 5-fold increased cardiovascular mortality risk: aHR, 4.9 (95% CI, 3.8-23.7).
- Increases continuing to 12 months were also a red flag.
- 5-year absolute incident risk by 4-month levels:
- >25% with >99th percentile.
- Prospective, multicenter, observational study, 1776 patients with ACS event and no recurrence within 4 months.
- Mean follow-up after 4-month troponin measure, 4.8 (maximum, 9.2) years.
- Funding: Health Research Council of New Zealand, others.
- Observational study.